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Irani: Why sports medicine?

This is a question that I am often asked not only by patients, but also by colleagues and students, who also sometimes ask if the discipline should be termed ‘sports injuries’ or ‘sports medicine’.

It is true that injury is a prevalent condition that limits athletic performance, but the general health of the athlete is paramount to the achievement of optimal results.

Repairing an injury does not guarantee that the athlete will once more reach peak performance if he or she is deconditioned or otherwise in need of attention.

In Ancient Rome athleticism was considered an attribute that could raise an individual and his family from a lesser social status to that of a hero; this is still true of modern-day sporting performances.

The apothecaries of old who attended on athletes attempted to restore not only physical condition but also the normal metabolic balance of the individual, using techniques that remain largely unknown.

Today athletes seem to choose their sport, and the role of their trainer or coach is to encourage their enthusiasm, something that is even more important even than physical condition.

The need for an the discipline of sports medicine has long been debated. For example, should a sportsperson with a problem that is thought to be cardiac in origin attend a sports physician or a cardiologist? Ideally, a cardiologist should take account of the stresses imposed on individual athletes as a result of their sport. However, would a cardiologist be aware of the rules and regulations appertaining to medications or to the technique that may be required in particular sports?

The counterargument is that, if physicians are to be rounded clinicians, they should receive some training in the area of sports medicine, in general, so that they are able to offer the best advice and care for their patients. Such a strategy is to be applauded as it would result in physicians who are not only specialists but also cognizant of athletes’ expectations of treatment.

The whole development of the human has also to be borne in mind. In this issue we have tried to cover not only elite sport but also the stresses that are imposed on the growing skeleton, the changes in physiology and, of course, the psychology of maturation from childhood through adolescence to adulthood.

This is not to ignore senior athletes who wish to continue or indeed to take up sporting activity. The population is ageing and the prevalence of diseases associated with age is increasing. Those who attend the elderly should support and encourage them to participate in sport to the benefit of both their physical health and social engagement.

Governments should seriously consider the need to develop medical support for sportspersons of all ages because a healthy population not only imposes less strain on the economy but experiences better quality of life.

I hope that the pure essence of sport will not be corrupted by genetic manipulation or by intervention by physicians who purport to be experts in a medical specialism that demands the same level of training as any other.

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